European Radiology

, Volume 25, Issue 12, pp 3552–3559 | Cite as

Assessing hepatic fibrosis: comparing the intravoxel incoherent motion in MRI with acoustic radiation force impulse imaging in US

  • Chih-Horng Wu
  • Ming-Chih HoEmail author
  • Yung-Ming Jeng
  • Po-Chin Liang
  • Rey-Heng Hu
  • Hong-Shiee Lai
  • Tiffany Ting-Fang ShihEmail author



This study compared the diagnostic performance of intravoxel incoherent motion (IVIM) in magnetic resonance imaging (MRI) and acoustic radiation force impulse imaging (ARFI) in ultrasound (US) for liver fibrosis (LF) evaluation.


A total of 49 patients scheduled for liver surgery were recruited. LF in the non-tumorous liver parenchyma at the right lobe was estimated using a slow diffusion coefficient, fast diffusion coefficient (D fast), perfusion fraction (f) of the IVIM parameters, the total apparent diffusion coefficient of conventional diffusion-weighted imaging and the shear wave velocity (Vs) of ARFI. LF was graded using the Metavir scoring system on histological examination. The Spearman rank correlation coefficient for correlation and analysis of variance was used for determining difference. The diagnostic performance was compared using receiver operating characteristic curve analysis.


LF exhibited significant correlation with the three parameters D fast, f, and Vs (r = −0.528, −0.337, and 0.481, respectively, P < 0.05). The D fast values in the F4 group were significantly lower than those in the F0, F1 and F2 groups. D fast exhibited a non-inferior performance for diagnosing all fibrosis grades compared with that of Vs.


Both IVIM and ARFI provide reliable estimations for the noninvasive assessment of LF.

Key Points

Liver fibrosis can be diagnosed and graded using noninvasive imaging modalities.

ARFI and IVIM can be incorporated into routine examinations.

IVIM can differentiate liver cirrhosis from none to moderate liver fibrosis.

The diagnostic performances of IVIM and ARFI are equal.


Liver cirrhosis Hepatectomy Hepatitis Magnetic resonance imaging Ultrasound 



total apparent diffusion coefficient


acoustic radiation force impulse


area under curve


incoherent microcirculation within the voxel (fast component)


true molecular diffusion (slow component)


dynamic contrast-enhanced magnetic resonance imaging


diffusion-weighted imaging


diffusion fraction


hepatocellular carcinoma


intravoxel incoherent motion


Jonckheere–Terpstra test


liver cirrhosis


liver fibrosis


magnetic resonance elastography


magnetic resonance imaging


receiver operating characteristic


transient elastography




shear wave velocity



The scientific guarantor of this publication is Tiffany Ting-Fang Shih. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, cross sectional study, performed at one institution.


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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Chih-Horng Wu
    • 1
    • 2
  • Ming-Chih Ho
    • 3
    Email author
  • Yung-Ming Jeng
    • 4
  • Po-Chin Liang
    • 1
    • 2
  • Rey-Heng Hu
    • 3
  • Hong-Shiee Lai
    • 3
  • Tiffany Ting-Fang Shih
    • 1
    • 2
    Email author
  1. 1.Department of Medical ImagingNational Taiwan University HospitalTaipeiTaiwan
  2. 2.Department of RadiologyNational Taiwan University College of MedicineTaipeiTaiwan
  3. 3.Department of SurgeryNational Taiwan University Hospital and College of MedicineTaipeiTaiwan
  4. 4.Department of PathologyNational Taiwan University Hospital and College of MedicineTaipeiTaiwan

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